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Purpose: The aim of this study was to identify prognostic factors in stage IVB colorectal cancer in elderly patients, focusing on the influence of treatment modalities, including palliative chemotherapy and primary tumor resection.

Methods: A cohort of 64 patients aged over 65 years who presented with stage IVB colorectal cancer at the Gangneung Asan Hospital between July 1, 2001, and December 31, 2009, was analyzed. Demographics, tumor location, tumor grade, performance status, levels of carcinoembryonic antigen (CEA), level of aspartate aminotransferase (AST), and distant metastatic site at diagnosis were analyzed. Using the treatment histories, we analyzed the prognostic implications of palliative chemotherapy and surgical resection of the primary tumor retrospectively.

Results: The cohort consisted of 30 male (46.9%) and 34 female patients (53.1%); the median age was 76.5 years. Primary tumor resection was done on 28 patients (43.8%); 36 patients (56.2%) were categorized in the nonresection group. The median survival times were 12.43 months in the resection group and 3.58 months in the nonresection group (P < 0.001). Gender, level of CEA, level of AST, Eastern Cooperative Oncology Group performance status, tumor location, and presence of liver metastasis also showed significant differences in overall survival. On multivariate analysis, male gender, higher level of CEA, higher AST level, and no primary tumor resection were independent poor prognostic factors. In particular, nonresection of the primary tumor was the most potent/poor prognostic factor in the elderly-patient study group (P = 0.001; 95% confidence interval, 2.33 to 21.99; hazard ratio, 7.16).

Conclusion: In stage IVB colorectal cancer in elderly patients, resection of the primary tumor may enhance survival.

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기사명 저자명 페이지 원문 목차
Only the Size of Resected Polyps Is an Independent Risk Factor for Delayed Postpolypectomy Hemorrhage : A 10-Year Single-Center Case-Control Study 문희석, 박선욱, 김동환, 강선형, 성재규, 정현용 pp.182-185

Overview of Radiation Therapy for Treating Rectal Cancer 계봉현, 조현민 pp.165-174

Prognostic Implications of Primary Tumor Resection in Stage IVB Colorectal Cancer in Elderly Patients 안희준, 오호석, 안용철, 이상진, 김현중, 김문호, 엄대운, 곽재용, 한명식, 송재석 pp.175-181

Enhancing the Enhanced Recovery Program in Colorectal Surgery-Use of Extended-Release Epidural Morphine(DepoDur®) Rajeev Peraval, Rachael Brock, Elizabeth Bright, Patricia Mills, Dawn Petty, Justin Albertsi pp.186-191

Application of Advancement Flap After Loose Seton Placement : A Modified Two-Stage Surgical Repair of a Transsphincteric Anal Fistula Metin Ertem, Hakan Gok, Emel Ozveri, Volkan Ozben pp.192-196

Mesh-Based Transperineal Repair of a Perineal Hernia After a Laparoscopic Abdominoperineal Resection 이택구, 이상전 pp.197-200

Regression of Colonic Adenomas After Treatment With Sulindac in Familial Adenomatous Polyposis : A Case With a 2-Year Follow-up Without a Prophylactic Colectomy 김규영, 전성우, 박정길, 류정훈, 장세영, 이재광, 황희영 pp.201-204

참고문헌 (21건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin 2009;59:225-49. 미소장
2 National Cancer Information Center [Internet]. Goyang: National Cancer Information Center; c2012 [cited 2013 Jan 26]. Available from: http://www.cancer.go.kr. 미소장
3 Annual Report of the Korea Central Cancer Registry Program 2000: Based on Registered Data from 131 Hospitals. 소장
4 Elective bowel resection for incurable stage IV colorectal cancer: prognostic variables for asymptomatic patients 네이버 미소장
5 Palliative operations for colorectal cancer 네이버 미소장
6 Liu SK, Church JM, Lavery IC, Fazio VW. Operation in patients with incurable colon cancer--is it worthwhile? Dis Colon Rectum 1997;40:11-4. 미소장
7 Beham A, Rentsch M, Pullmann K, Mantouvalou L, Spatz H, Schlitt HJ, et al. Survival benefit in patients after palliative resection vs non-resection colon cancer surgery. World J Gastroenterol 2006;12:6634-8. 미소장
8 Costi R, Mazzeo A, Di Mauro D, Veronesi L, Sansebastiano G, Violi V, et al. Palliative resection of colorectal cancer: does it prolong survival? Ann Surg Oncol 2007;14:2567-76. 미소장
9 Kleespies A, Fuessl KE, Seeliger H, Eichhorn ME, Muller MH, Rentsch M, et al. Determinants of morbidity and survival after elective non-curative resection of stage IV colon and rectal cancer. Int J Colorectal Dis 2009;24:1097-109. 미소장
10 The prognostic factors of stage IV colorectal cancer and assessment of proper treatment according to the patient’s status 네이버 미소장
11 Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer 네이버 미소장
12 Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. 네이버 미소장
13 Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. 네이버 미소장
14 Predictors of Survival in Stage IV Metastatic Colorectal Cancer 네이버 미소장
15 Factors predicting survival in stage IV colorectal carcinoma patients after palliative treatment: A multivariate analysis 네이버 미소장
16 Complete Single Stage Management of Left Colon Cancer Obstruction with a New Devices 네이버 미소장
17 Multivariate Analysis of the Survival Rate for Treatment Modalities in Incurable Stage IV Colorectal Cancer. 소장
18 Colorectal cancer: evidence for distinct genetic categories based on proximal or distal tumor location. 네이버 미소장
19 Comparison of 17,641 patients with right- and left-sided colon cancer: differences in epidemiology, perioperative course, histology, and survival. 네이버 미소장
20 A systematic review of the role of school-based healthcare in adolescent sexual, reproductive, and mental health. 네이버 미소장
21 Jess P, Hansen IO, Gamborg M, Jess T; Danish Colorectal Cancer Group. A nationwide Danish cohort study challenging the categorisation into right-sided and left-sided colon cancer. BMJ Open 2013;3:e002608. 미소장

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